Synopsis While on passage from Gjoa Haven to Resolute Bay, the HANSEATIC ran aground in Simpson Strait. The weather was fine and clear and the vessel was being navigated visually, by reference to shore ranges, and by radar. The passage plan was disrupted when it was assumed that a buoy, which had been left in the strait from the previous navigation season, was marking a shoal. The buoy had been moved out of position by ice. The Board determined that the HANSEATIC grounded because the bridge team did not strictly adhere to the plan that had been prepared for navigating the vessel through the strait. Relying on a navigation buoy left in the strait from the previous navigation season contributed to the grounding. 1.0 Factual Information 1.1 Particulars of the Vessel 1.1.1 Description of the Vessel The HANSEATIC is of typical passenger ship construction with the superstructure extending the entire length of the vessel abaft a short foredeck. The navigation bridge is situated at the forward end of the superstructure. The navigation bridge is of modern design. The control console is situated forward in the wheel-house. There are three radars in the wheel-house, one to each side and one near the centerline. The view forward is unobstructed but, because of the superstructure, it is not possible to see astern from inside the wheel-house. To improve visibility astern, the bridge wings extend outside the superstructure. A manoeuvring console with a gyro-repeater is fitted on each wing. The HANSEATIC is an up-market passenger vessel which, since 1993, has specialized in what have been variously described in the maritime press as expedition cruises or adventure cruises. Where no port facilities exist, the vessel's outfit of small boats allows passengers to disembark for tours ashore. The vessel's hull is ice-strengthened. 1.2 History of the Voyage On 29 August 1996, the HANSEATIC was in the eleventh day of a Northwest Passage cruise which had started in Nome, Alaska, and was to have terminated in Greenland. The cruise had taken the vessel to several communities in Alaska, Yukon and the Northwest Territories. On the morning of 29 August, the HANSEATIC made an eastbound passage in Simpson Strait to the village of Gjoa Haven where she was to anchor for part of the day, while passengers went ashore for a tour of the village. During the trip, several buoys were unexpectedly found in the strait. The master had not anticipated seeing any buoys in the strait because the Arctic Canada Traffic System (NORDREG CANADA) had advised him that the buoys for Simpson Strait were still on board the CCGS SIR WILFRID LAURIER, as the ice breaker had not yet had an opportunity to position them. The majority of the range markers for the various legs of the inbound passage were positioned ahead of the vessel and the passage was straightforward and uneventful. Little attention was paid to the buoys or whether they were in their charted positions. The HANSEATIC left Gjoa Haven in the afternoon of 29 August for Resolute Bay. Initially, the voyage to Resolute required that the HANSEATIC retrace her morning passage through Simpson Strait, in a westerly direction. The route involves many alterations of course and, as on the inward passage, the master had the conduct of the vessel. With him on the bridge were a helmsman and the chief officer who assisted with the navigation. The ship, which has an operating speed of 14 knots, was making about 10 knots and no difficulty was experienced with the initial part of the transit. A position taken at 1738,[3] confirmed that the vessel was proceeding parallel to, and approximately a cable south of, the 288 course line indicated on the chart for the ranges on Eta Island. The vessel was south of the charted course line to avoid a 6.1 metre shoal reported near the track. Once past the shoal, and approximately half way along this leg, the HANSEATIC was brought back towards the 288 course line. At 1745, a check of the ship's position by the chief officer showed the vessel abeam of the northwest extremity of SaatuqIsland and almost exactly on the 288 course line. The vessel was at this point about half a mile from the next alter-course position, and the chief officer turned his attention to setting up the radar for the next leg. Meanwhile, the master was monitoring the vessel's position relative to the 288 course line by reference to the Eta Island ranges. Because the ranges were astern of the vessel, and with the helm orders ranging from 290 to 293, the master had to frequently go out to the starboard wing of the bridge to check the ranges. The master was reportedly keeping the ship on a heading which was increasingly to starboard of the course line to counteract the effect on the vessel of the northwest wind. As the HANSEATIC approached the alter-course position, the master was aware that the ship was north of the ranges, but the sight of a green buoy on the starboard side gave him confidence that she would pass clear of a shoal lying just to the north of the course line. However, the buoy had not been removed at the end of the previous navigation season and the winter ice had moved it about 200 metres to the northeast. Consequently, the HANSEATIC did not clear the shoal and ran aground in position 68 33.75' N, 097 32.2' W. As the vessel was not considered to be in any danger, during the next few days, while awaiting assistance, passengers were afforded the opportunity to explore adjacent islands, using the ship's boats. On 05 September 1996, with the exception of a few who had requested to be flown home, the passengers were transferred to another vessel to carry on with their NorthwestPassage cruise. Following several unsuccessful attempts, the vessel was finally refloated on 08 September 1996, with the help of the tug EDGAR KOTOKAK and the coast guard cutter NAHIDIK. 1.3 Injuries to Persons No one was injured as a result of the grounding. 1.4 Damage Damage was limited to the underwater hull between frames 77 and 126. The shell plating was holed and severely rippled on both sides of the centreline girder but there was no pollution as a result of the occurrence. 1.5 Certification 1.5.1 Vessel The vessel was certificated, crewed and equipped in accordance with existing regulations. 1.5.2 Vessel's Navigation Personnel Both the master and the chief officer held qualifications appropriate for the tonnage of the vessel on which they were serving and for the voyage being undertaken. 1.6 Personnel Experience The master of the HANSEATIC had 26 years' experience as master on a wide variety of passenger vessels. Although he had sailed in the Canadian Arctic on several occasions, this was his first voyage through Simpson Strait. The chief officer of the HANSEATIC had 25 years' sea-going experience, 10 as master. He had seven months' experience on board the HANSEATIC as chief officer. 1.7 Bridge Team The master, chief officer and helmsman were on the bridge prior to, and at the time of, the grounding. Although an ice navigator was on board the HANSEATIC, at this time of year the vessel was permitted to navigate in the Simpson Strait area without his aid, and he was not on the bridge during the passage. The bridge team was well rested at the time of the occurrence. 1.8 Environmental Information 1.8.1 Weather The weather was fine and clear with a northwesterly wind of 17 to 21 knots. The sea was calm in the sheltered waters of the strait and the visibility was reported to be about 5 miles. The air temperature was 7C; the sea temperature was 4C. 1.8.2 Tide and Tidal Stream According to the Sailing Directions - Arctic Canada, Volume I, the average tidal range in SimpsonStrait is about 0.6 m. The range for the tidal cycle during which the grounding occurred was calculated to be about 0.5 m. The grounding occurred about four hours after highwater. The Sailing Directions advise that the tidal stream, from brief and broken observations, is rectilinear, running roughly parallel to the axis of the strait... They also caution that ...tidal streams up to 4 knots, and up to 7 knots near Eta Island, have been experienced, with marked changes of direction, tide-rips and backeddies around the islets and shoals. On Canadian Hydrographic Service (CHS) chart No. 7735, tide rips are indicated in the area of the grounding. From an analysis of the information available, the Institute of Marine Sciences in Sidney, B.C., formed the opinion that they ...would not expect there to be a strong deflection of the current from the along-channel direction in the vicinity of the range line... They concluded that ...currents were unlikely to be a significant factor in carrying the Hanseatic off the range line. 1.9 Navigation of the Vessel 1.9.1 Navigation Equipment The vessel's navigation equipment was reportedly in satisfactory condition. Two radar sets were being used in the navigation of the vessel and no deficiency was reported. The Global Positioning System (GPS) was not being used. Positions obtained by GPS in Simpson Strait can be off by as much as one mile, when plotted on the chart. This lack of precision is due to the inaccuracy of geographical coordinates on charts of the area. 1.9.2 Charts and Publications The marine chart being used by the vessel was the CHS chart No. 7735, Simpson Strait. Many areas of the Arctic coast are either incompletely or inaccurately charted, or both. The geographical coordinates are not accurate on some charts (including chart No. 7735) but the shore lines and other features on chart No. 7735 are correctly depicted relative to each other. Positions obtained from the radar and by visual means will be accurately represented on thechart. The Sailing Directions - Arctic Canada, Volumes 1 and 3 are relevant to the area of the occurrence and these publications were on board the HANSEATIC. 1.9.3 Aids to Navigation The Sailing Directions advise that the channel through Simpson Strait is marked by beacons, beacon ranges and buoys. The Sailing Directions also advise that the buoys in Simpson Strait are seasonal. However, because the Canadian Coast Guard (CCG) policy is that the operational requirement for ice-breakers takes precedence over the removal of the buoys in the strait, the buoys are not always removed at the end of the shipping season. Each season, the CCG does not consider the strait to be buoyed until a Notice to Shipping is issued, specifically stating that the buoys for the area have been deployed. Such a Notice to Shipping had not been issued at the time of the occurrence. Although the buoys are built to be expendable, some of the buoys are not destroyed during the winter and remain afloat in the strait or grounded on adjacent beaches. Buoys that remain afloat are almost invariably displaced from their charted positions. While the buoy that marked the shoal on which the HANSEATIC grounded had been moved about 200 metres to the northeast, the buoy that marked the shoal on the other side of the channel was found some 1,300 metres to the west of its charted position. A stretch of some 20 miles of the navigation channel depicted on CHS chart No. 7735 comprises eleven legs, eight of which are defined by a set of shore range markers. Persons experienced in navigating in the Arctic advise that, because some of the range markers are built on low islands, they may be pushed out of position by the ice and mariners must be cautious when using them. Six of the eight sets of range markers are ahead for an eastbound vessel. The 108-288 range markers on Eta Island were checked after the HANSEATIC grounding and were found to be in their correct positions. All aids to navigation in Simpson Strait are unlit. 1.9.4 Cautionary Notes Regarding Buoyage Canadian publications relevant to a passage through Simpson Strait contain several warnings against relying on buoys in the area. A note on chart No. 7735 states that the channel leading through Simpson Strait is marked by seasonal buoys which are liable to be displaced by ice. All Sailing Directions published by the Department of Fisheries and Oceans (DFO) advise that mariners should not rely on buoys being in their charted positions at all times. Buoys should be regarded as warning markers and .. . Masters should always navigate by bearings or angles on fixed shore objects. The Sailing Directions - Arctic Canada, Volume 1 also warns that buoys laid in Arctic waters must be regarded merely as temporary and very unreliable aids to navigation . . . and they are always liable to be carried away by the movement of ice . . . The Sailing Directions - Arctic Canada, Volume 3 advises that buoys in Simpson Strait are seasonal and consist of four oil drums welded together end-to-end and painted red or green. Some years, because of ice conditions, it is not possible to lay the buoys, and since buoys in these ice-strewn waters cannot be depended upon to remain in their correct positions for very long, little reliance can be placed on them. 1.10 Passage Planning and Bridge Resource Management The master and the chief officer had been involved in the planning of the passage. The SailingDirections describe the passage through Simpson Strait as probably the greatest navigational hazard in the whole mainland passage . . . because of numerous shoals, narrow channels and strong tidal streams. This publication also states that numerous dangerous shoals . . . lie close to the channel and it is probable that these are altered considerably by ice action each season. In describing the topography, the Sailing Directions advise that on the north side of Simpson Strait, the . . . coast presents a low, regular and rather featureless appearance, with no distinctive landmarks while the south . . . coast is somewhat higher than the north coast but its overall elevation is moderate gradually rising to distant hills . . . The islands in Simpson Strait consist mainly of stones and large boulders, and . . . tend to blend in with each other and with the adjacent shoreline. For the passage in Simpson Strait, the master had the conduct of the ship and the chief officer was assisting by plotting the vessel's position. In the parts of the strait where the alignment of the channel is indicated by shore leading marks (ranges), any lateral displacement of the vessel from the alignment could be quickly detected by the master. To indicate the vessel's progress along the alignment of the channel, radar distances and bearings of the shore were to be obtained and plotted by the chief officer. No supplementary parallel indexing was being used when the vessel was on the Eta Island range markers, but parallel indexing was to be used on the next leg. With the vessel proceeding westbound on these two legs, the range markers were astern. When the vessel was proceeding on the Eta Island course, the radar distance ranges used varied with the application. 1.11 Ice Navigator According to the Arctic Shipping Pollution Prevention Regulations, the HANSEATIC was not required to carry an ice navigator, although an ice navigator had been on board since the vessel departed Nome. The HANSEATIC was in open water at the time of the grounding and the ice navigator was not on the bridge--nor was he required to be. 1.12 Post-grounding Assistance and Refloating the Vessel 1.12.1 Assistance Following the grounding, the master contacted NORDREG to inform them of the situation and to request towage assistance. The CCGS NAHIDIK was in the area and was tasked to assist the stranded vessel. The NAHIDIK was on the scene at 0334, 30 August. In the morning of 30 August, the CCGS HENRY LARSEN was also tasked to be part of the response. However, her draught prevented her from entering the channel and she had to remain about a hundred nautical miles from the site. On 05 September 1996, the CCGS LOUISST.LAURENT was tasked to replace the HENRY LARSEN but her draught was also too great for her to reach the scene. 1.12.2 Refloating Operation On 30 August, the NAHIDIK twice attempted to free the HANSEATIC by pulling her from the stern. On the second attempt, the tow line parted and work was suspended for the day. Another attempt was planned for 31 August but the NAHIDIK damaged her foremast while manoeuvring to receive an anchor from the HANSEATIC and all further attempts were cancelled pending the arrival of commercial assistance. On 05 September, the passengers left the vessel. Those who had not requested to be flown home were transferred by air to a Russian passenger ship with ice-breaking capability, the KAPITAN DRANITSYN. The owners of the HANSEATIC had chartered the KAPITANDRANITSYN, which had been available in the area after a promotional engagement. Ten crew members from the HANSEATIC also transferred to the Russian vessel to assist with the passengers. On 07 September, the HANSEATIC off-loaded an anchor and chain, and most of her fuel to a barge brought alongside by the Canadian tug EDGAR KOTOKAK. The lifeboats and zodiacs were put in the water. The next day, 08 September, the NAHIDIK and the EDGARKOTOKAK were made fast to the HANSEATIC and the stranded vessel was successfully refloated at 1033. 1.12.3 Search and Rescue Although no distress call was sent by the HANSEATIC, the Rescue Coordination Centre at Trenton was notified of the grounding. There is not a lot of marine activity in the Canadian Arctic and no primary marine Search and Rescue (SAR) resource is assigned to the area. The major marine activity in the area consists mostly of commercial resupply and government operations. During the last eight summers, on average, three passenger vessels cruised for two to three weeks in the Canadian Arctic. Coast Guard ice-breakers and DFO scientific vessels provide secondary coverage during the summer and early fall. Most marine SAR incidents in the area are resolved with the use of primary air resources as opposed to marine resources. Three C-138 Twin Otter aircraft and one C-130 Hercules aircraft provide coverage throughout the region. Traffic in Simpson Strait is minimal and no shipping accident had previously been reported in the area, since computerized records were begun in 1975. 1.13 Policy Regarding Passengers It is the on-board policy to allow passengers on the bridge of the HANSEATIC while the ship is underway. The navigating personnel are used to the presence of passengers and reportedly are not distracted by them. The cruise director and about twenty passengers were present on the bridge during the westbound transit of Simpson Strait. They were standing in a designated area confined by ropes at the back of the bridge, in silence. The master did not realize they were there until after the grounding, and it is unlikely they distracted him. The passengers present on the bridge described the atmosphere as being serious and professional. 1.14 Situational Awareness Situational awareness can be defined as the accurate perception of the factors and conditions affecting the crew and the operations of the vessel during a specific period of time. This is developed by using all the knowledge that is accessible and can be integrated into a coherent picture, when required, to assess and cope with a situation.[4] A person performing a complex task such as ship navigation depends on situational awareness when making and carrying out plans throughout the operation. Situational awareness does not happen instantaneously, but develops on three different levels. First, the person has to perceive the situational elements from information displays, communication, or from external references. The person then integrates the information by using his/her experience and knowledge. Finally, the person projects the information into the future to make and modify plans as tasks are completed or delayed and new developments arise. In general, it can be expected that poor or unsuccessful performance will occur if there are problems at any one of these situational awareness levels.[5] One of the ways that the integration of information can be erroneous is when a person is affected by confirmation bias. This is a tendency to seek information to confirm that which we already believe to be true. Information that is inconsistent with the chosen hypothesis is then ignored or discounted.